Pacemaker/ICD and resynchronization

I was hoping the "Bri-Guy75" would see this. I posted on the "PVC controversary" thread, but my question might have gotten buried.

Otherwise, is anyone familiar with ICD implants that can answer this question?

My dad had a pacemaker/ICD implanted a couple of months ago. There are 3 leads on the implant. The implant is working great, but sometimes the third lead gives him the sensation of hiccups in his abdomen (it is in a vein that runs along the nerve). Because the third lead is kind of a bonus to help with cardiac resynchronization, the doctor said if the "hiccups" become too bothersome he can shut off the lead.

What are your thoughts on leaving the wire in place (regardless of the hiccup feeling)? Is it still beneficial? Or, is it best to turn off the lead? The technician did induce significant arrythmias and other than the "hiccup" feeling, the implant is working great. Thanks for any input.

The hiccup feeling has got to be annoying, but I think I would be inclined to put up with it. As mmfd noted, the Bi-V pacemakers are some remarkable devices. That said, I would encourage him to ask more questions of the EP about benefits and drawbacks of symptoms versus making any changes.

You are both exactly right. He has a Bi-V pacemaker with the hopes of improving heart function. My dad had a pacemaker implanted aboutn 8 years ago and b/c he is considered "at risk" for a cardiac event, replacement of the pacemaker included the addition of a defibrillator.

The insertion of the Bi-V pacemaker was a bit of an after-thought. The doctors felt that since they were inserting a defib and pacemaker, they would implant a Bi-V pacemaker in the hopes of improving his EF. He is somewhat symptomatic of CHF, but does well. The doctor is hoping the new unit will improve the SOB and overal heart function.

The doctor has told my dad that he does not want him to be annoyed by the "hiccup" feeling, and will disconnect the lead if necessary. Like you both mentioned, I'm thinking if he can tolerate the feeling, why not try for the benefit. Apparently, the placement of the 3rd lead can be tricky in some patients, and in this case, in my dad. So far, he is tolerating the hiccup feeling and will see the EP in March. Fortunately, it does not happen all the time, but when it does it is usually when he is trying to rest/sleep.

If you are talking about a biventricular pacemaker, I know several people who have had dramatic improvements in their heart failure since implant. Their EF's have risen a lot and their heart size has returned to normal! Of course, this doesn't always happen but it can be an important therapy for those who qualify. I believe if they shut off that third lead, then there would be no benefits toward resynch. How about another opinion with a different EP? Things are still new enough with those that some may have more experience with the device than others. Just a thought......

I have one and it has dramaticly changed my life!!! For the first time in a decade I have hope for a future. I was at only 15% heart function and now under doctor supervision I am working with Voc Rehab and hope to rejoin the Workforce and get off Disability! I had the Hiccups at first but a couple adjustments have cleared them up.

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